Xenon-Enhanced Computed Tomography in Brain Death

Darby, Joseph M.; Yonas, Howard; Gur, David; Latchaw, Richard E.

doi:10.1001/archneur.1987.00520170077027

Cited by 39 publications

(10 citation statements)

References 30 publications

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“…This study showed that CTP and MRP can detect 1-4% of normal CBF, i.e., 0.6-2.4 mL/100 g/min, amounts that are much smaller than those causing irreversible brain damage (10-12 mL/100 g/min) reported in earlier studies [12,13]. In addition, the values are smaller than the previously suggested cut-off value for the diagnosis of brain death, i.e., 5 mL/100 g/min [14,15].…”

Section: Discussionmentioning

confidence: 64%

CT and MR perfusion can discriminate severe cerebral hypoperfusion from perfusion absence: evaluation of different commercial software packages by using digital phantoms

et al. 2011

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Section: Discussionmentioning

confidence: 64%

CT and MR perfusion can discriminate severe cerebral hypoperfusion from perfusion absence: evaluation of different commercial software packages by using digital phantoms

et al. 2011

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“…Contrast angiography is invasive, not available around the clock and exposes potential donor organs to toxic contrast media [8]. Although xenon-enhanced CT is the most reliable confirmatory test [19], it is not routinely available, due to technical problems associated with the handling of xenon-133, and in addition xenon-133 has low gamma energy (81 keV) and X-radiation (31 keV) that contributes to extracerebral flow [20].…”

Section: Discussionmentioning

confidence: 99%

Confirmation of Brain Death Using Brain Radionuclide Perfusion Imaging Technique

Al-Shammri

Alfeeli²

2004

Med Princ Pract

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Objective: To determine the reliability of radionuclide cerebral blood perfusion imaging in confirming brain death irrespective of continued heartbeat. Subjects and Methods: Twenty-eight patients (19 male and 9 female, aged 17–63 years) with severe brain injury and fully supported until the final cardiac asystole were included in the study. Two sets of clinical tests aimed at ascertaining brain death in each subject were performed separately for each case within an interval of 24 h. Dynamic, planar and single photon emission computed tomographic (SPECT) brain scintigraphy were also performed after intravenous administration of 550 MBq (15 mCi) technetium-99m hexamethyl propyleneamine oxime. Results: Following the clinical diagnosis of brain death, none of the patients was withdrawn from cardiopulmonary support or had any organ harvested. Dynamic, planar and SPECT imaging performed thereafter did not reveal any intracranial cerebral perfusion in any of the subjects, except in 1 patient where the initial scan showed posterior fossa activity that ceased, in a subsequent scan obtained after 24 h. All of the patients were declared dead only after the emergence of cardiac asystole. Conclusion: The findings indicate that radionuclide brain perfusion imaging is reliable, reproducible, noninvasive and simple to perform for the confirmation of brain death and as such we recommend it as an alternative to exhaustive neurophysiological tests and invasive catheter angiography.

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“…The other observation is that Xe/CT can record very low LCBF values (<10 ml/100 g/min), even in small and centrally located brain regions. Experience with animal models 15 and with clinical cases of focal cerebral ischemia 4 -6 and brain death 16 suggests that this technology is able to record very low LCBF values that are consistently accompanied by irreversible infarction. Although Xe/CT provides some advantages, it also has significant disadvantages.…”

Section: Discussionmentioning

confidence: 99%

Cerebral blood flow determination within the first 8 hours of cerebral infarction using stable xenon-enhanced computed tomography.

Hughes

Yonas

Gur

et al. 1989

Stroke

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Cerebral blood flow mapping with stable xenon-enhanced computed tomography (Xe/CT) was performed in conjunction with conventional computed tomography (CT) within the first 8 hours after the onset of symptoms in seven patients with cerebral infarction. Six patients had hemispheric infarctions, and one had a progressive brainstem infarction. Three patients with very low (<10 ml/100 g/min) blood flow in an anatomic area appropriate for the neurologic deficit had no clinical improvement by the time of discharge from the hospital; follow-up CT scans of these three patients confirmed infarction hi the area of very low blood flow. Three patients with moderate blood flow reductions (15-45 ml/100 g/min) in the appropriate anatomic area had significant clinical improvement from their initial deficits and had normal follow-up CT scans. One patient studied 8 hours after stroke had increased blood flow (hyperemia) in the appropriate anatomic area and made no clinical recovery. (Stroke 1989;20:754-760)

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Xenon-Enhanced Computed Tomography in Brain Death

Cited by 39 publications

References 30 publications

CT and MR perfusion can discriminate severe cerebral hypoperfusion from perfusion absence: evaluation of different commercial software packages by using digital phantoms

CT and MR perfusion can discriminate severe cerebral hypoperfusion from perfusion absence: evaluation of different commercial software packages by using digital phantoms

Confirmation of Brain Death Using Brain Radionuclide Perfusion Imaging Technique

Cerebral blood flow determination within the first 8 hours of cerebral infarction using stable xenon-enhanced computed tomography.

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